Exploring meals in Maltese families : a socio-ecological study

Abstract

Several studies have been conducted locally about the food choice behaviours of individuals, particularly of children and adolescents, yet research on food choice at the family level is scarce. This gap is knowledge is particularly significant given that meal provision can greatly influence the well-being of all family members. This study aimed at exploring the influences on the planning, preparation and consumption of the main weekday meal in families. A socio-ecological framework was adopted as this enabled a comprehensive analysis of the phenomenon by considering influences within all levels of the environment and the relationships between them. An exploratory, sequential, mixed methods approach was taken, where the results of each stage were used to develop the next stage. Initially, interviews were conducted to gain a general understanding of the issues at play within a relatively new area of research. This enabled the development of a quantitative instrument. Follow-up focus group interviews were conducted to clarify and further explore the quantitative results obtained from the survey. Results revealed that meal provision was primarily the mothers' responsibility. Meal provision in families was influenced by several factors within all levels of the environment. The micro level emerged as the most influential. Three key players were identified here, namely the mother, family food preferences and practices and parental employment. The mother had great influence, not only on the type of meal chosen but also on food preparation and consumption practices. The family was an equally important influence, which greatly impacted the practices of the mother. Individual preferences of children were identified as particularly important. Other family practices, such as various schedules and commitments, eating out practices and TV viewing practices influenced several aspects of meal provision. Parental employment was the most powerful demographic influence on meals in families and was an important marker of differences between groups of families. Other influencing factors within the meso, exo and macro levels of the environment were identified and included TV and advertising, availability and accessibility to food, traditional cuisine, cultural norms and religious practices. These, however, were less important. Analysing results according to children's school type and level of education and employment status of main food providers revealed some differences among groups. Other demographic markers such as family size and age of children were not indicators of difference. Based on these results it is recommended that public health or nutrition educators focus on the family as a unit and take into account the various influences that impinge on meal provision such that educational interventions targeted at parents will be more relevant to the context of the family. Educational interventions should also try to target fathers as well as children and adolescents and encourage their greater participation in family meal provision. A draft outline of an educational intervention based on the findings of this study is indeed presented.